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Gastroenterology and Hepatology

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Introduction

The department of Gastroenterology and Hepatology at the Royal Adelaide Hospital provides specialised assessment and care of patients with problems of the gastrointestinal tract and liver, including diseases of the oesophagus, stomach, small and large bowel and the pancreas. The Department also has state-of-the-art endoscopic services and an internationally recognised gastrointestinal function testing laboratory.

The Department has close functional links with the surgical gastroenterology units: upper gastrointestinal surgery, colorectal and pancreato-biliary that collectively form the Centre for Digestive Diseases.



Pictured: Gastroenterology and Hepatology Unit consultant staff

Director, and Head of Gastrointestinal Function Testing Laboratory
Professor RH Holloway

Head of Clinical Hepatology
Assocociate Professor HAJ Harley

Head of Gastrointestinal Investigation Unit
Dr MN Schoeman

Head of Inflammatory Bowel Disease Services
Associate Professor JM Andrews

Staff specialists
Dr NQ Nguyen
Dr WCE Tam
Dr M LeMire
Dr FDL Bartholomeusz
Dr P Kuo
Dr EYL Tse
Dr G Nind

Visiting consultants
Dr MJ Arens
Dr JM Argyrides
Dr DJ Hetzel
Dr RD Johnson
Associate Professor CE Rayner
Dr John Bate

Location

The Gastroenterology and Hepatology Unit offices are located in the Gastrointestinal Investigation Unit in Ward Q7, Level 7, North Wing.

Gastroenterology and Hepatology inpatients are usually located in Ward Q6, Level 6, North Wing.

The Outpatient Clinic is located on Level 7 of the Outpatients Building.

Clinical services

The department of Gastroenterology and Hepatology provides specialised assessment and care of patients with problems of the gastrointestinal tract and liver, in both acute inpatient and outpatient care settings.

Gastroenterology

  • gastrointestinal bleeding disorders
  • inflammatory bowel disease
  • peptic ulcer and reflux disease
  • malabsorption
  • gastrointestinal motility and functional disorders
  • biliary and pancreatic diseases

Hepatology

  • chronic hepatitis
  • metabolic liver diseases (eg haemochromatosis)
  • cirrhosis
  • portal hypertension
  • general hepatobiliary diseases
  • fibroscan
  • liver biopsy

Inpatient services

Acute Inpatient Care

The Department of Gastroenterology and Hepatology has 15-20 inpatient beds for the management of specialised gastrointestinal and hepatobiliary problems. The Department also runs a specialised Haematemesis and Melaena service in partnership with the Oesophago-Gastric Surgical Unit for the management of patients with acute upper gastrointestinal bleeding.

Consultative Service

An important part of the inpatient workload involves providing a consultative service to other medical and surgical units at the hospital. Requests for consultations should be arranged through the Gastroenterology Registrar or resident, who can be contacted through the Royal Adelaide Hospital switchboard.

Outpatient services

Gastroenterology Clinics

Clinics are held for patients with general gastroenterological problems as well as for inflammatory bowel diseases, motility or functional gastrointestinal disorders, and pancreato-biliary diseases.

Outpatient bookings:
Telephone: (08) 8222 5589
Clinics are held on Monday, Tuesday, Wednesday and Thursday afternoons.

A number of gastroenterologists have the expertise and special interest in providing care for patients with the following conditions:

  • gastrointestinal motility and functional disorders
    Prof RH Holloway, Assoc. Prof. JM Andrews, Dr P Kuo
  • inflammatory bowel disease
    Assoc. Prof. JM Andrews, Dr D Hetzel, Assoc. Prof. CK Rayner
  • hepato-pancreato-biliary disorders and interventional endoscopy
    Dr M Schoeman, Dr N Nguyen, Dr WCE Tam.

Download the Gastroenterology Clinic referral form.

Liver Diseases Clinic

This clinic was established in 1994 and is held on Monday afternoons. It is attended by Associate Professor H Harley, Dr M LeMire, Dr R Johnson, Dr M Arens, Dr E Tse and the Senior Gastroenterology Registrars. Patients with liver disease referred to the RAH can be referred directly to the Liver Diseases Clinic. The Clinic provides for integrated management of patients with close liaison with the Infectious Diseases Unit, Hepatobiliary Surgical Unit and the Drug and Alcohol Resource Unit. We have extensive experience with antiviral (Interferon) therapy of chronic viral hepatitis.

Patients with the following problems can be referred to this Clinic:

  • abnormal liver tests
  • alcoholic liver disease
  • viral Hepatitis B or C
  • cirrhosis
  • hepatic masses
  • haemochromatosis
  • drug induced liver disease
  • cholestatic diseases
  • ascites / Portal hypertension
  • transplantation assessment.

The RAH Hepatology Service works in close association with the South Australian Liver Transplant Unit. Associate Professor H. Harley and Dr E. Tse (Hepatologists) and Mr P. Dolan (Hepatobiliary Surgeon) are involved in the pre and post transplant management of these patients.

Download the Liver Clinic referral form.

Gastrointestinal Investigation Unit

The Gastrointestinal Investigation Unit provides state-of-the-art endoscopic services including endoscopic ultrasound and cholangioscopy, and manometric assessment for oesophageal and ano-rectal disorders.

Endoscopy

  • upper and lower endoscopy
  • ERCP and interventions
  • endoscopic ultrasound and related interventions
  • endoscopic mucosal resection of polyps and early mucosal tumours
  • capsule and balloon enteroscopy
  • SpyGlass cholangioscopy

Motility and functional testing

  • oesophageal manometry
  • ambulatory oesophageal pH monitoring
  • post-prandial oesophageal manometry and pH monitoring
  • anorectal manometry
  • endo-anal ultrasound

The Endoscopy Unit provides the following diagnostic and therapeutic procedures:

Diagnostic procedures

  • upper gastrointestinal endoscopy
  • transnasal endoscopy
  • capsule and balloon enteroscopy
  • colonoscopy and sigmoidoscopy (flexible and rigid)
  • endoscopic ultrasound and guided biopsy
  • endoscopic retrograde cholangio pancreatography (ERCP)
  • SpyGlass cholangioscopy and electrohydraulic lithotripsy
  • liver biopsy

Therapeutic procedures

  • oesophageal dilatation
  • variceal sclerotherapy/banding
  • oesophageal stenting
  • ulcer injection
  • polypectomy
  • argon plasma coagulation
  • removal of foreign bodies
  • diathermy
  • percutaneous endoscopic gastrostomy (PEG)
  • gastric or enteric feeding tubes
  • abdominal paracentesis
  • haemorrhoid treatment
  • endoscopic sphincterotomy CBD stone removal
  • biliary or pancreatic stent insertion
  • biliary or pancreatic stricture dilation
  • biliary electrohydraulic lithotripsy
  • colo-rectal stricture dilation
  • enteral stent insertion.

Download the Endoscopic Procedure referral form.

Gastrointestinal Function Testing Services

The Gastrointestinal Function Testing Laboratory performs investigation of the motor (muscular) function of the gastrointestinal tract. Procedures include:

  • oesophageal manometry
  • ambulatory oesophageal pH monitoring
  • ambulatory oesophageal manometry
  • post-prandial oesophageal manometry and pH monitoring
  • anorectal manometry
  • endo-anal ultrasound.

Download the Manometric Investigation referral form.

Training

The Gastroenterology and Hepatology Unit is fully accredited with the Royal Australasian College of Physicians for training in Gastroenterology. There are two funded clinical training positions each year. However, depending on funding, a position for those who are interested in doing Fellowship in Hepatology and/or Interventional Endoscopy may be available. It is also possible to accept other applicants (national or international) for training if they have outside funding.

Direct your expression of interest in writing to either of the following:

Professor Richard H Holloway
Email: Richard.Holloway@health.sa.gov.au

Associate Professor Hugh AJ Harley
Email: Hugh.Harley@health.sa.gov.au

Associate Professor Jane Andrews
Email: Jane.Andrews@health.sa.gov.au

Contact details:
Department of Gastroenterology and Hepatology
Royal Adelaide Hospital
North Terrace
Adelaide SA 5000
Australia
Telephone: +61 (8) 8222 5207
Fax: +61 (8) 8222 2414

Research

The Gastroenterology and Hepatology Unit has a vigorous research program that has an international reputation and regularly attracts trainees and senior investigators from overseas.

A number of research projects related to various aspects of Gastroenterology and Hepatology are currently conducted in our Department, including:

  • evaluating gastrointestinal motility in chronically ill and obese patients
  • drug therapies for inflammatory and functional bowel diseases
  • prognostic biomarkers of pancreatic cancer
  • applications of emerging endoscopic techniques
  • drug therapies for viral hepatitis - there are laboratories for both clinical research (in the Gastrointestinal Investigation Unit) and basic science research (in the Hanson Research Centre).

Specific research projects with lead investigators in the field of Gastroenterology and Hepatology include:

Field

Lead investigators and contact details

Drug therapies in IBD and IBS
Functional GI Disorders
Reflux Disease

A/Prof. J Andrews
Jane.Andrews@health.sa.gov.au

Prof. RH Holloway
Richard.Holloway@health.sa.gov.au

Nutrition and GI motility in
obesity, chronic liver disease and critically ills.

Dr NQ Nguyen
Nguyen.Quoc@health.sa.gov.au

EUS guided biopsy for prognostic biomarkers in pancreatic cancer

Dr NQ Nguyen
Nguyen.Quoc@health.sa.gov.au

Interventional Endoscopy (EMR, enteroscopy, capsule endoscopy)

Dr MN Schoeman
Mark.Schoeman@health.sa.gov.au

Dr NQ Nguyen
Nguyen.Quoc@health.sa.gov.au

Glycaemic control and GI motility in diabetics and obesity

A/Prof. C Rayner
Chris.rayner@adelaide.edu.au

Dr NQ Nguyen
Nguyen.Quoc@health.sa.gov.au

Viral Hepatology and other hepatological research

A/Prof. H Harley
Hugh.Harley@health.sa.gov.au


In addition, basic research in hepatology is performed at the Institute of Medical and Veterinary Science/Hanson Research Centre. Research involves pathophysiology, and cell and molecular biology in the fields of iron metabolism and haemochromatosis, regulation of hepatic drug metabolising enzymes and the mechanisms of hepatic injury and regeneration. Research in the area of viral hepatitis is conducted in conjunction with the Hepatitis Virus Research Laboratory in the department of Molecular Biosciences at the University of Adelaide.

There are a number of research fellows and opportunities exist for interested people to undergo research training with a view to a higher degree (MD or PhD). Limited opportunities for funding, in the form of scholarships, exist within the RAH campus.